ABSTRACT
Objectives: To determine if a positive family history of glaucoma, overtime, translates to a more severe form of the disease
Methods: A retrospective chart review of 359 consecutive patients diagnosed with primary openangle glaucoma [POAG] and normal tension glaucoma was performed. Family history of glaucoma, age, gender, race, cup/disk [C/D] ratio, visual field [VF] defects, intraocular pressure [IOP], central corneal thickness [CCT], and current glaucoma medications were recorded. Characteristics of patients with positive family history [Group A] and negative family history[Group B] were compared using Fisher's Exact and Wilcoxon Rank sum tests for categorical and continuous variables, respectively
Results: There were 144 [40.1%] patients in Group A and 215 [59.9%] patients in Group B. Racially, both groups were similar, p= 0.44. Patients in Group A were younger at diagnosis, [61.9 +/- 13.5 years vs 65.2 +/- 12.5; p=0.02], had greater percentage of females [50.7% vs 37.7%; p= 0.02], had thicker CCT, microm, [546 +/- 58.1 vs 532.7 +/- 40.2; p=0.02], higher IOP [16.6 +/- 3.9 vs 1.6 +/- 3.9; p= 0.02], advanced [C/D >/= 0.9] cupping [32.2% vs 22.4%; p=0.05] and higher prevalence of moderate to severe VF defects [66.2% vs 54.8%, p= 0.04], compared with normal to mild VF defects
Conclusion: Our study has suggested that a positive family history of glaucoma may be associated with higher IOP, as well as greater prevalence of advanced cupping and moderate to severe VF defects. Vigilance and aggressive treatment are warranted for these patients
ABSTRACT
Objective: To determine if central corneal thickness influences Intra Ocular Pressure [IOP] lowering response of Selective Laser Trabeculoplasty [SLT] in patients with medically uncontrolled primary open angle glaucoma
Methods: Consecutive patients who received selective laser trabeculoplasty during May 2011 through June 2013 were enrolled in this retrospective chart review study. Information gathered included age, gender, race, central corneal thickness and type of glaucoma. Number of glaucoma medications, visual acuity, and IOP were assessed before and after treatment
Results: Data from 48 patients [77 eyes] were used in the analysis. There were no significant differences in the number of glaucoma medications used or visual acuity before or after treatment. IOP measurements decreased 10.3% over preoperative levels through 18-months from a mean preoperative pressure of 18.4 +/- 5.5 to 16.5 +/- 4.7 mmHg [P < 0.0005]. The mean central corneal thickness was 533.8 +/- 38.0 mm. The treated eyes were divided into two groups by central corneal thickness: thin [<555mm], and thick [>555mm]. There was no difference in mean IOPs of the groups preoperatively, but during the 18 months follow-up there was a significant mean change in intraocular pressure within the thin group [-2.5 mmHg, 95%CI [-3.8, -1.2], p=0.0002] but not in the thick group [-1.6mmHg, 95% CI [-3.4, +0.2], p=0.08]. However, the difference between the central corneal thickness groups was not statistically significant
Conclusions: Selective laser trabeculoplasty was more effective in reducing IOP, when used as an adjunct to medical therapy for glaucoma, in patients with thin central corneal thickness [<555mm] than those with thick central corneal thickness [>555mm]